Provider Demographics
NPI:1902806011
Name:MILLER, KARL SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:SCOTT
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 SPRINGVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8153
Mailing Address - Country:US
Mailing Address - Phone:843-871-4006
Mailing Address - Fax:843-871-4074
Practice Address - Street 1:92 SPRINGVIEW LN
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8153
Practice Address - Country:US
Practice Address - Phone:843-871-4006
Practice Address - Fax:843-871-4074
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10446207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC104461Medicaid
SCD092158041Medicare PIN
D09215Medicare UPIN
SC104461Medicaid